How well do stents keep the common femoral artery open over two years?

Details

Endovascular therapy is the treatment of choice for arteriosclerotic lesions in many vascular segments, but surgical reconstruction is still considered the gold standard for common femoral artery (CFA) lesions.

This retrospective, single-center study evaluated the safety and efficacy of CFA stent angioplasty in a real-world population over a two-year follow-up period. It included 250 patients requiring stent angioplasty for CFA lesions. The primary endpoint was the target lesion revascularization (TLR) rate. Secondary endpoints were the overall procedural complication rate, the rate of ipsilateral CFA punctures during follow-up, changes in Rutherford–Becker class (RBC) and ankle–brachial index (ABI), primary patency rates, amputation rate, and the time to and type of TLR.

A total of 236 interventions (94.4%) were successful, with success defined as residual stenosis below 30%. There were 23 complications (9.1%) around the intervention, three of which required surgical treatment. Median follow-up was 21 months, and mean follow-up was 19.2 ± 7.8 months.

Overall, 41 patients (16.4%) needed TLR. Primary patency rates were 90.8%, 81.2% and 72% at 6, 12 and 24 months, respectively. ABI and RBC were significantly better than baseline at every assessed time point. Seven amputations were performed during follow-up: three minor and four major. More than half of the patients (56.0%) underwent puncture of the stented CFA during follow-up.

Multivariate logistic regression analysis identified continued nicotine use and coronary heart disease as predictors of TLR. The authors concluded that stent angioplasty for CFA lesions is safe and effective. Further studies are needed to compare this endovascular option with surgical therapy.